应用彩色多普勒及免疫组化技术检测人膀胱多发移行细胞癌中血管生成活性的意义(1)
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[摘要] 目的 探讨术前检测多发膀胱移行细胞癌血管生成活性的意义,探讨其与盆腔淋巴结转移的关系。 方法 采用彩色多普勒血流显像(CDFI)技术检测21例术前膀胱癌患者血流信号定量测定阻力指数(RI),同时应用免疫组化技术检测膀胱癌术前活检组织和术后肿瘤内微血管密度(MVD),分析两者与盆腔淋巴结转移的关系。 结果 盆腔淋巴结转移组(LM+组)CDFI检测RI值明显低于无盆腔淋巴结转移组(LM-组),差异有显著性(P<0.05);LM+组MVD较LM-组差异有显著性(P<0.01);术前活检组织MVD与术后肿瘤内MVD比较差异无显著性(P>0.05);反映血管生成活性的RI值与MVD两者具有良好的相关性(负相关,P<0.01)。 结论 多发膀胱癌血管生成活性与盆腔淋巴结转移密切相关,血管生成活跃者淋巴结转移可能性大,CDFI对膀胱癌活体肿瘤内血流检测和术前膀胱镜活检组织内MVD检测相结合,可以作为临床判断盆腔淋巴结转移和手术范围的指标。
[关键词] 彩色多普勒超声;膀胱癌;多发;阻力指数;新生血管
中图分类号:R445文献标识号:A文章编号:1005-0515(2010)09-046-02
【Abstract】 Objective To study the significance of angiogenetic activity examined before operation and investigate the relationship between angiogenetic activity and pelvic lymph node in human multiple bladder cancer. Methods Vascularizations of bladder cancer from 21 cases were observed by Color Doppler flow image to measure resistance index (RI).The microvessel density (MVD) of the biopsy specimen of the bladder cancer obtained before and after operaion was assessed by immunohistochemistry. Results The value of RI of pelvic lymph node metastasis group (LM+ group) was much higher than that of no pelvic lymph node metastasis group (LM- group) (P<0.05).MVD of LM+ group was higher than that of LM- group (P<0.01).There was no difference between MVD of biopsy specimen obtained before operation and MVD of tumor (P>0.05).The value of RI which reacted angiogenetic activity was negative correlative to MVD (P<0.01). Conclusions Angiogenetic activity of multiple bladder cancer is closely correlated with pelvic lymph node metastasis.CDFI and MVD of the biopsy from tumor before operation may serve as a parameter for determining tumor metastasis potential and operation area.
[Key Words]Color Doppler Ultrasound bladder cancer multiple resistance indexangiogenesis
膀胱癌是泌尿系统最常见的恶性肿瘤,如美国2002年有56500例新诊病例[1]。其中以膀胱移行细胞癌多发(bladder transitional cell carcinoma,BTCC)[2]。肿瘤发生时,瘤灶及瘤周将会发生持续的、失控的血管生成;恶性肿瘤的发生、发展及转移的各阶段均有赖于新生血管的形成[3]。淋巴是肿瘤细胞转移的重要途径,50%以上的肿瘤细胞经淋巴转移。盆腔淋巴结是膀胱癌最主要的转移部位[2]。我们应用彩色多普勒血流显像技术(CDFI),结合免疫组化方法分别检测多发膀胱癌术前活检组织和术后肿瘤组织内微血管密度(MVD),探讨检测膀胱癌血管生成活性及与盆腔淋巴结转移的关系。
1 材料与方法
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